FAQ – Facts

By age 50, about 50% of men—and a substantial number of women—are affected by hair loss, much of which is hereditary. Hair transplantation surgery is a state-of-the-art special procedure for the correction of male pattern baldness, scarring alopecia, and other causes of permanent alopecia. It involves removing some of the hair-bearing scalp from the back of the head where “permanent” hair grows and planting it in the bald area in tiny seedlings or “grafts.” The hair continues to grow in the bald region just as it was doing in the back(the permanent hair from the back of the head normally grows for life). The area from which the hair is removed at the back of the head is called the “donor site.” It is closed with stitches or staples, heals quickly, and the scar is concealed with the remaining hair.

There are currently no good alternatives for hair and in fact alternatives to transplantation aren't great. Hairpieces are a hassle. They're expensive (frequently more than transplants over the long term), they often look unnatural, and they can come off or move out of place unexpectedly, causing embarrassment. And some physicians think that hairpieces actually kill more hair. One alternative, Rogaine,® is a nonprescription hair growth medicine applied to the scalp. It works for only about 25 to 50 percent of users. And, if you stop using it, any new hair will fall out. Propecia® is another medicine that comes in pill form. It works well if you have some hair left, but also must be taken daily for an indefinite length of time. Although side effects are usually modest or none, your doctor should periodically monitor your treatment. So transplantation is often the best choice. Most “new hair” seen on the heads of American men these days involves the minor surgery of hair transplantation.

Hair transplantation can be done both on patients with advanced baldness and earlier thinning. In general, hair transplantation is not considered for patients younger than their mid 20s because of difficulty in predicting ultimate extent of hair loss.

Hair surgery requires both medical and technical expertise as well as an aesthetic appreciation of natural hair growth. Here your transplant will be performed by a team led by Dr Vafaei, a Board-certified specialist in dermatology with training and experience in dermatologic surgery. He is a dermatologic surgeon, experienced in hair transplantation, as well as other cosmetic and reconstructive skin surgeries. He received his qualifications in Dermatology in 1998. He is trained in hair transplantation surgery.

No. Of course, most hair transplant patients are men between the ages of 30 and 50, but you may be surprised to learn that women also suffer from hair loss and lots of our clients are ladies. Over 200,000 people had hair transplants in 1994 (more than four times the 1990 rate), and of those, about 13,000 were women.

Women with localized thinning on the top of their heads or thinning around the temples often make good candidates for hair transplantation. Prior to evaluation for hair transplantation, it is important for women to discuss your thinning hair with a dermatologist and/or endocrinologist to make sure there is no other treatable reason for the hair loss.

The list of these factors is very long but some of more important of them are:

Age, Sex, Past medical history, Current physical condition, Current medications, Degree of hair loss, Rate of hair loss, Past hair restoration treatments (medical hair restoration and/or surgical hair restoration), Family history, Your thoughts and expectations, and many more.

We believe in the dignity and intelligence of our patients. We spend a significant amount of our energy to publish information that will be of benefit to our patients so that patients can have the best answers to their questions. Our aim is to provide straightforward, understandable information so patients are empowered to make their own decisions about hair restoration. For those who desire surgery, we are proud to offer Follicular Unit Transplantation techniques at very affordable rates.

Even in the most extreme balding patterns, a permanent 'wreath' of hair exists on the sides and back of the head. This hair is unaffected by the balding process. In Follicular Unit Hair Transplantation, a thin strip of skin containing this permanent hair is removed from the back of the head (because the skin of the scalp is flexible, the scalp can be sutured together again after the strip is removed leaving little trace that anything was done). The hair follicles are then carefully removed from that piece of skin and placed in very small surgical sites made in the thinning or balding areas of the scalp. Once transplanted, this hair behaves as it was programmed to behave in the original area it came from and will grow naturally for the rest of your life.

Most men in good general health are candidates for hair transplantation. In order to determine your candidacy, you should arrange to have a free, private consultation with a NHI physician. During your consultation, the physician will measure your donor density and scalp laxity. He will also determine your balding pattern and take your individual hair characteristics such as color and wave into consideration to develop a plan for your hair restoration.

We routinely schedule a second surgery 8-12 months after the first for the following reasons: 1.At 8-12 months, hair length is adequate to see the effects of styling. With that in mind, the patient can work concomitantly with the surgeon to make many of the decisions regarding further distribution of grafts, and the process is more'owned' by the patient. 2.Occasionally, when hair first begins to grow, its texture may be slightly different from your original hair. After 8-12 months this generally returns to normal making decisions about the grooming easier, and grooming preferences may affect the way the next procedure is planned. 3.Some patients have cyclical growth, which means that all of the growth may not be in and of adequate length at 4 or 5 months. Waiting the few extra months gives the person enough time to see hair growing and this can be a psycholigical advantage for the patient. 4.Seeing the hair allows the surgeon to clearly see where to place the new grafts. For those patients with tighter scalps, the skin has a greater time to restore some of its previous laxity.

If you have a completely bald area, it may take two to three surgeries to cover. If you have an area partially covered with hair, it may take only one surgery to fill in the area. Our goal is to restore about twenty-five percent to thirty-five percent of the donor's original density in each surgery. After two surgeries, the density is at about fifty to sixty percent which is often adequate coverage to satisfy the patient. The time between each session is usually four to six months in order to see how the hair is growing out and to provide more equal distribution.

You may have heard that the process is very painful. But with the proper technique in the application of anesthesia, it does not have to be a painful process at all. It all depends on how the surgeon applies the anesthesia, and our office uses the least painful process available for the comfort of our patients.

For a hair transplantation process, every surgeon uses either a nerve blocking process or a local anesthesia (general anesthesia is never used in this case).

Any pain at all during our procedure would be during the initial needle injection. Our office uses a special kind of Anesthesia Method to reduce even this small pain. The anesthetic is warmed to reduce reaction time, the skin is pre-numbed before each localized shot and the finest gauge needle (30 gauge) is used to minimize this pain. Initially, the patient is given a sedative through an IV medication. This sedative puts the patient into a relaxed, "twilight zone" state to minimize any pain there might be from the subsequent injections. The tumescent technique is used for prolonging the anesthesia time. Most patients have informed us that the process was less painful than a routine trip to the dentist. In addition, the day after the hair transplant process, 50% of our patients do not require any pain relievers at all, and the other 50% will take pain reliever for only one or two days until the discomfort is gone.

We feel that our procedures are much less painful in comparison to many other clinics. The only disadvantage to this "twilight zone" anesthesia is that the patient will not be able to drive on the day of the surgery. However, should the patient forego the "twilight zone" anesthesia and opt instead for a local anesthesia, he will be able to drive on that day.

Maintain an adequate length of hair on the back of your head. Your donor grafts will be removed from here and you should expect coverage following your procedure.

Two weeks before surgery: No Aspirin (acetylsalicylic acid - A.S.A.) or anti-inflammatory medications that contain Aspirin. One week before surgery: 1) No Vitamin E. 2) No Ginkgo Biloba, Ginseng or other herbal supplements. One day before surgery; 1) No Alcohol. 2) Make arrangements for someone to take you to and from the clinic if you want to have I.V. sedation in addition to local anesthesia. 3) Confirm your appointment. On surgery day:
Wash your hair in the morning using your regular shampoo.
Have a light meal one hour prior to your procedure.
Wear a button-down shirt and comfortable, easily laundered pants. You should also bring an adjustable baseball cap or scarf along with you. No tight hats or caps. Do not wear anything that will have to be pulled tightly over your head. Eat a light meal just before coming to the clinic